Comparative Genomics Identifies Features Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission in Hospital Settings

Adedrian, Timileyin; Hitchcock, Stephanie; O’Hara, Lyndsay M.; Michalski, Jane; Johnson, J. Kristie; Calfee, David P.; Miller, Loren G.; Hazen, Tracy H.; Harris, Anthony D.; Rasko, David A.

doi:10.1128/msphere.00116-22

Cited by 2 publications

(2 citation statements)

References 59 publications

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“…We selected the patient isolates in proportion to the number of the isolates that were identified as part of the different genomic clades identified in our previous study. 14 We then selected a paired HCP sample at random, either a glove or gown isolate from an HCP who provided care to the patient whom we selected previously. Figure 1 outlines how isolates were selected through the various steps of the current study.…”

Section: Isolate Selectionmentioning

confidence: 99%

“…We identified 4 main phylogenetic groups among the paired isolates, which corresponded to the 4 main phylogenetic groups identified in the parental genomic study. 14 The most frequent transmission type among the patient isolates was midlevel transmitters (n = 64 of 91, 70%), which were defined as MRSA transmitted to the HCP at rates between 1% and 49%, based on the examination of 10 HCP-patient interactions. The remaining 27 patient isolates (30%) were considered high transmitters, defined as a transmission rate >50%, based on the examination of 10 HCP-patient interactions.…”

Section: Phylogenetic Analysis Of Mrsa Paired Isolatesmentioning

confidence: 99%

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Molecular concordance of methicillin-resistant Staphylococcus aureus isolates from healthcare workers and patients

Adediran

Hitchcock²,

Johnson³

et al. 2022

Infect. Control Hosp. Epidemiol.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant nosocomial pathogen in the ICU. MRSA contamination of healthcare personnel (HCP) gloves and gowns after providing care to patients with MRSA occurs at a rate of 14%–16% in the ICU setting. Little is known about whether the MRSA isolates identified on HCP gown and gloves following patient care activities are the same as MRSA isolates identified as colonizing or infecting the patient. Methods: From a multisite cohort of 388 independent patient MRSA isolates and their corresponding HCP gown and glove isolates, we selected 91 isolates pairs using a probability to proportion size (PPS) sampling method. To determine whether the patient and HCP gown or gloves isolates were genetically similar, we used 5 comparative genomic typing methods: phylogenetic analysis, spa typing, multilocus sequence typing (MLST), large-scale BLAST score ratio (LSBSR), and single-nucleotide variant (SNV) analysis. Results: We identified that 56 (61.5%) of isolate pairs were genetically similar at least by 4 of the methods. Comparably, the spa typing and the LSBSR analyses revealed that >75% of the examined isolate pairs were concordant, with the thresholds established for each analysis. Conclusions: Many of the patient MRSA isolates were genetically similar to those on the HCP gown or gloves following a patient care activity. This finding indicates that the patient is often the primary source of the MRSA isolates transmitted to the HCP, which can potentially be spread to other patients or hospital settings through HCP vectors. These results have important implications because they provide additional evidence for hospitals considering ending the use of contact precautions (gloves and gowns) for MRSA patients.

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Section: Isolate Selectionmentioning

confidence: 99%

Section: Phylogenetic Analysis Of Mrsa Paired Isolatesmentioning

confidence: 99%

Molecular concordance of methicillin-resistant Staphylococcus aureus isolates from healthcare workers and patients

Adediran

Hitchcock²,

Johnson³

et al. 2022

Infect. Control Hosp. Epidemiol.

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Skin colonization by Staphylococcus aureus in hemodialysis patients with pruritus and the effect of Staphylococcus aureus‐secreted α‐toxin on filaggrin expression

Tsai,

Chen,

Chang

et al. 2024

The Journal of Dermatology

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Staphylococcus aureus (S. aureus) commonly reside on human skin in residents in long‐term care facilities, yet its colonization and impact on the skin of hemodialysis (HD) patients have yet to be studied. The aim of the present study was to investigate the colonization of S. aureus on the skin of pruritic and non‐pruritic HD patients, and the influence of S. aureus and S. aureus‐secreted α‐toxin on skin barrier function‐related protein expression. In this study, a higher relative S. aureus count in pruritic HD patients compared to non‐pruritic HD patients and healthy subjects were revealed by real‐time polymerase chain reaction. S. aureus and α‐toxin decreased mRNA and protein expression levels of aryl hydrocarbon receptor (AHR), ovo‐like transcriptional repressor 1 (OVOL1), and filaggrin (FLG) in keratinocytes. In addition, anti‐alpha‐hemolysin (anti‐hla) was used as an α‐toxin neutralizer, and it successfully abrogated S. aureus‐induced AHR, OVOL1, and FLG mRNA and protein expression downregulation. Mechanistically, α‐toxin could decrease FLG activity by preventing the recruitment of AHR to the FLG promoter region. In conclusion, pruritic HD patients had higher S. aureus colonization, with S. aureus‐secreted α‐toxin suppressing FLG expression through the AHR‐FLG axis.

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Comparative Genomics Identifies Features Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission in Hospital Settings

Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is considered a serious threat to public health and contributes to the dissemination of S. aureus in both the healthcare and community setting. Transmission of MRSA between patients via healthcare worker (HCW) has been described.

Cited by 2 publications

References 59 publications

Molecular concordance of methicillin-resistant Staphylococcus aureus isolates from healthcare workers and patients

Molecular concordance of methicillin-resistant Staphylococcus aureus isolates from healthcare workers and patients

Skin colonization by Staphylococcus aureus in hemodialysis patients with pruritus and the effect of Staphylococcus aureus‐secreted α‐toxin on filaggrin expression

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